Endometriosis Treatment

The course of endometriosis treatment is determined largely by the patients wishes regarding a future pregnancy. If a patient wants to maintain her pregnancy options, it is crucial that she communicate these wishes to her physician, as many types of endometriosis treatment will render a woman permanently infertile. A woman’s physician will be able to discuss endometriosis treatment options that will not prevent future pregnancy.

Endometriosis Treatment and Pregnancy

Surgery is considered the best endometriosis treatment for patients desiring pregnancy. This form of endometriosis treatment involves the surgical removal of endometrial tissue, with the goal to increase a patient’s fertility and subsequent chance of pregnancy.

Today, endometriosis treatment using laparoscopic (“key-hole”) surgery is becoming increasingly popular, as it causes minimal scarring and has a speedier recovery period.

Hysterectomy, or complete removal of the uterus, is only recommended for patients with severe, chronic pelvic pain, and for whom pregnancy is no longer an issue.

New Endometriosis Treatment

New findings, reported in the American Journal of Obstetrics and Gynecology, suggest that endometriosis treatment is more effective if the pelvic pain nerves are also cut during laparoscopic surgery. This type of combination surgery is a particularly beneficial endometriosis treatment for patients suffering from chronic, midline abdominal pain.

Drugs for Endometriosis Treatment

When the prime objective of endometriosis treatment is pain relief and the patient is not concerned about pregnancy in the future, the following types of medication are often used.

Oral contraceptives: A common endometriosis treatment, oral contraceptives are administered alone or in combination with other drugs. Oral contraceptives, however, may take up to three months to be effective, and are associated with the development of blood clots in some women.

Hormone endometriosis treatment: Gonadotropin-releasing hormone (GnRH) agonists are often used as a treatment for endometriosis. Although GnRH is known to induce characteristic menopausal symptoms, such as mood swings, vaginal dryness, hot flashes and reduced bone density, the drug is nevertheless, an effective endometriosis treatment because it reduces the patient’s natural levels of estrogen.

Progestins: Often used in combination with other endometriosis drug treatments, such as oral contraceptives, progestins are considered suitable for patients who are not concerned about pregnancy. Progestins may cause irregular bleeding, fluid retention, and reduced levels of beneficial HDL (the “good”) cholesterol.

Over-the-counter medications: NSAIDs, including naproxen and ibuprofen, are proven pain-relievers used to treat endometriosis.

Danazol: An anti-gonadotropin endometriosis treatment, danazol, simulates the effects of testosterone and works by inhibiting ovulation. Pregnancy, however, must be ruled out before taking danazol. In addition, possible adverse side-effects of taking Danazol include weight gain, oily skin, acne and the development of androgenic male characteristics, such as abnormal hair growth and deepening of the voice.

Oral contraceptives, given after endometriosis treatment with danazol or GnRH agonists, may slow the progression of endometriosis and are a highly effective combination endometriosis treatment for women wishing to delay pregnancy. Clinical trials indicate subsequent pregnancy rates following drug treatment for endometriosis ranging between forty and sixty percent.

Endometriosis Clinical Trials

Current clinical trials are looking at safer, more effective endometriosis drug treatments. Such drugs include SERMs, drugs that act like estrogen on some tissues, but block the effect of estrogen on other tissues, and aromatase inhibitors, drugs used to block the synthesis of estrogen.

Resources

Farley, D. (1997, September). On the teen scene: Endometriosis: Painful, but treatable. FDA Consumer [Publication No. (FDA) 93-1205]. Retrieved August 26, 2003, from www.fda.gov/fdac/reprints/ots_endo.html.

Georgia Reproductive Specialists. (2003). Endometriosis. Retrieved August 26, 2003, from www.ivf.com/endohtml.html.

Reproductive and Placental Research. (2002). Endometriosis research. Retrieved August 26, 2003, from info.med.yale.edu/obgyn/kliman/Endometriosis/endometriosiswelco me.html.

Reuters Health. (2003, July). Cutting pain nerves may help menstrual cramps. Retrieved August 26, 2003, from www.reuters.com/newsArticle.jhtml? type=healthNews